Kornimate/medical-research-clean huggingface dataset:
evaluation of a standardized strategy for uveitis etiological diagnosis

Conditions: Uveitis

Summary: the uveitis, the inflammation of the uvea, is a rare disease with an incidence of 52/100,000 inhabitants per year and a prevalence of 115 / 100,000 inhabitants per year. the causes of uveitis are numerous and include infectious diseases, systemic and neurological diseases, ophthalmic entities, neoplasia, and drug-related reactions. the etiological diagnosis is important both for prognosis and therapeutics. however, clinical evaluations to establish etiological diagnosis are not standardized. some authors suggest a minimalist examination, common to all kinds of uveitis. on the other hand, others propose an evaluation guided by the anatomo-clinical type of uveitis. we conducted a retrospective study to assess the contribution of complementary examinations to etiological determination. in this study, we found that most patients benefited from a wide paraclinical evaluation compared to what is usually described in the literature. complementary examinations were mostly systematic, without any clinical or ophthalmological elements of orientation. this study highlighted the lack of contribution of some examinations. using these results, and the literature analysis, we designed a diagnostic algorithm adapted to the anatomo-clinical type of uveitis. moreover, we found that the average cost per patient was estimated at €290.51 with the algorithm compared to €560.83 without it. we would like to carry out a new study to estimate the efficiency as well as the medico-economic impact of the use of a standardized strategy for the etiological diagnosis of uveitis, compared with a free strategy. hypothesis: * the standardized strategy for the diagnostic of uveitis is at least as efficient as the free one, and costs half as much. * the examinations prescribed, except for those from the standardized strategy, do not contribute to etiological determination.


Eligibility criteria:
inclusion criteria: * uveitis * patient consulting one of the study's sites * age \> 18 years old * affiliation to the french national health insurance program * patient agreeing to participate in the study exclusion criteria: * positive hiv serology * postsurgical or posttraumatic uveitis or endophthalmitis * toxoplasmic uveitis * pathology likely to be the cause of the known uveitis * ophthalmic entities only diagnosed by the ophthalmic examination * age \< 18 years old * patient under law protection or guardianship * pregnant women or those planning to be pregnant during the study * severe uveitis (va \< 20/200) with retinal vascularitis requiring an emergency treatment and assessment.

Keywords: uveitis etiological diagnosis standardized strategy
the anatomic determinants of perforation induced hearing loss

Conditions: Conductive Hearing Loss; Perforated Tympanic Membrane

Summary: the purpose of this study is to identify factors that may contribute to conductive hearing loss. conductive hearing loss is a type that is due to a problem with the outer or middle ear. because of this, sound does not travel through the ear normally. perforated tympanic membranes of study patients will be photographed during the patient's routine visit using a digital otoscope. these pictures will be used to analyze perforation size as an absolute value as well as a percentage of the tympanic membrane. audiometric results and ct scans of temporal bone (reports and images) collected as standard of care will be evaluated. images of ct scans will be imported into a medical imaging software for creation of anatomically realistic 3d models of the middle ear and mastoid air space. structural analysis on each 3d model will be conducted and analyzed, the volume of middle ear and mastoid air spaces will be recorded, and data points will be correlated with perforation size and location to audiogram results.


Eligibility criteria:
inclusion criteria: * between 18 and 89 years of age * confirmed diagnosis of conductive hearing loss secondary to tympanic membrane perforation * treated for the above condition by a duke physician * received both a ct temporal bone scan interpreted by a duke radiologist and audiometry at a duke-based facility (both tests performed within four weeks of each other), as part of standard pre-operative workup exclusion criteria: * temporal ct scan with inadequate resolution as per determination of study staff * unable to provide written informed consent * unable to read and understand english
triggers and risk factors for recurrence of atrial arrhythmias with the use of long-term monitoring

Conditions: Atrial Fibrillation; Atrial Flutter; Atrial Arrhythmia; Atrial Tachycardia; Premature Atrial Contractions; Arterial Hypertension; Sleep Disorder; Sleep Apnea; Stress; Physical Inactivity; Overexertion; Alcohol Drinking; Caffeine Dependence

Summary: a prospective cohort study to evaluate the association between various triggers encountered in daily life and induction of atrial arrhythmias (atrial fibrillation, atrial flutter, atrial tachycardia and premature atrial contractions) with the use of long-term monitoring devices. the collected data of personalized triggers and risk factors will be used to define the individual phenotype of atrial arrhythmia.


Eligibility criteria:
inclusion criteria: * patients with previously diagnosed paroxysmal or persistent atrial fibrillation who are in sinus rhythm at inclusion time. * an informed consent is signed by the patient. exclusion criteria: * the qualifying episode of af has never been documented in ecg or holter ecg monitoring. * patients with atrial fibrillation, atrial flutter or atrial tachycardia at inclusion time. * patients with permanent atrial fibrillation or permanent atrial flutter. * age \<18 years. * patients with a pacemaker or an implanted cardiovert-defibrillator. * patients suffering from dementia or other severe neurological disorders and thus incapable to participate. * patients who present with antisocial behavior and/or do not want to participate in the study.

Keywords: atrial fibrillation atrial flutter atrial arrhythmias arterial hypertension triggers sleep disorders sleep apnea telemedicine mhealth remote monitoring digital health
lung protection and pediatric cardiac surgery

Conditions: Lung Injury, Acute

Summary: the lung is at risk for ischemic insults during total cardiopulmonary bypass because lung perfusion is maintained solely by the bronchial arterial system

the study will be performed in the pediatric cardiothoracic unit, pediatric assiut university hospital. after obtaining approval from the local ethics committee and written informed parents consent 60 patients will be included in this study according to the following criteria:

Eligibility criteria:
inclusion criteria: * elective cardiac surgery * ventricular septal defect (vsd). * atrial septal defect (asd) exclusion criteria: * cyanotic heart disease. * patients with preoperative chest problems. * patients with known renal or hepatic dysfunctions. * planned off-pump cardiac surgery. * emergency cardiac surgery.

Keywords: lung cardiopulmonary bypass pediatric cardiac surgery
comparison between tamsulosin and tadalafil in management of benign prostatic hyperplasia long term study

Conditions: BPH

Summary: comparison between tamsulosin and tadalafil in management of benign prostatic hyperplasia a randomised trial

assessment of the discontinuation rate of tamsulosin and tadalafil after 12 months follow up either and evaluate the changes in urinary parameters and sexual parameters in patients with lower urinary tract symptoms due to bph concomitant with erectile dysfunction. we tried to overcome the limitations of the previous studies by designing a prospective randomized controlled trial as the present study is the first randomized controlled trial that evaluate the safety, discontinuation rate and efficacy of tadalafil compared with tamsulosin for long term follow up (12 months).

Eligibility criteria:
inclusion criteria: * patients with lower urinary tract symptoms * married and sexually active * age more than 50 years * ipss more than 12 * q max less than 15 ml/s * post voiding residual less than 150 ml exclusion criteria: * prostatic adenocarcinoma * cardiac patients on nitrates, patient with unstable angina or recent history of myocardial infarction * vesical stones * active urinary tract infection * patient refused participation in the study

Keywords: tamsulosin tadalafil bph randomised trial longterm discontinuation rate
effects of 2 initial standard antiretroviral combinations therapies on lipid metabolism

Conditions: HIV Infections

Summary: this study is an open-label, randomized, pilot comparison of the effects of either lopinavir/ritonavir or efavirenz in combination with tenofovir plus emtricitabine on cholesterol metabolism, mitochondrial functioning and immune response in 50 naive hiv patients after 48 weeks.


Eligibility criteria:
inclusion criteria: * chronic hiv-1 infection * age 18 or above * antiretroviral-naive * criteria for antiretroviral therapy in accordance with current guidelines * plasma ldl-cholesterol below 190 mg/dl * not receiving lipid-lowering agents * written informed consent exclusion criteria: * use of phytosterol-enriched food previous month. * pregnancy or breastfeeding * cardiovascular disease * secondary hypercholesterolemia * plasma creatinine above 1,2 mg/dl) * aminotransferases above 5 times uln * current treatment for hepatitis c coinfection * diabetes mellitus (fasting glycemia \> 124 mg/dl) * illegal drug use or alcohol abuse * active aids-defining opportunistic disease

Keywords: treatment naïve
the efficiency for stage ii-iii hr+/her2+ early breast cancer patient with standard neoadjuvant therapy in real world.

Conditions: Breast Cancer

Summary: to observe the efficiency for patient with stage ii-iii hr+/her2+ early breast cancer with standard neoadjuvant therapy, a retrospective, multicenter study in real world settings.

this study collected patients used standard neoadjuvant therapy (tcbhp/thp/ec-thp/ac-thp) among stage ii-iii hr+/her2+ early breast cancer, and to describe patient clinical characteristics and clinical outcomes of them in real world settings.

Eligibility criteria:
inclusion criteria: * age ≥18 years or older * hr+/her2- breast cancer diagnosis based on local standards * women having stage ii-iii breast cancer diagnosed based on ajcc cancer staging system (8th edition) who will be admitted because of breast cancer for the first time * standard therapy, determined at the discretion of the investigator, including （tcbhp/thp/ec-thp/ac-thp） * complete medical history was available * karnofsky performance status (kps) scale score ≥ 70 exclusion criteria: * women who have received any form of anti-tumor treatment - (chemotherapy, radiotherapy, molecular targeted therapy, or endocrine therapy) * pregnant or breast-feeding women * those who have bilateral breast cancer, inflammatory breast cancer or occult breast cancer * those who have stage iv breast cancer

Keywords: standard therapy （tcbhp/thp/ec-thp/ac-thp）
hed-start: evaluating a positive skills intervention for patients new on haemodialysis

Conditions: End Stage Renal Disease on Dialysis; End Stage Renal Failure on Dialysis; End Stage Renal Disease; End Stage Kidney Disease

Summary: hemodialysis patients often experience barriers and misperceptions that hinder adjustment to life on dialysis. this study seeks to explore a group-based intervention (titled hed-start) developed to improve self-care and emotional wellbeing among incident hemodialysis patients.

there are potentially modifiable psychosocial barriers and misperceptions about life on dialysis that hinder adjustment outcomes. it is hypothesized that these may include: poor understanding on what is needed or 'how to implement treatment principles', misperceptions related to disease and treatment, catastrophizing beliefs about impact of dialysis and low level of confidence on ability to manage treatment regime and renegotiate life roles as a "dialysis patient". this study seeks to explore the feasibility and acceptability of implementing a two-arm parallel randomized controlled trial of a group-based intervention (titled hed-start). hed-start is specifically developed to reduce psychological distress and support self-care and self-management outcomes in incident hemodialysis patients. drawing on self-management and motivational interviewing principles paradigm, the hed-start program aims to facilitate acquisition of skills and knowledge to support and improve self-care and emotional adjustment outcomes.

Eligibility criteria:
inclusion criteria: * patients diagnosed with end-stage kidney disease (eskd) and established on hemodialysis with the national kidney foundation singapore (nkf) for fewer than 90 days * at least 21 years old * proficient in spoken and written english or mandarin exclusion criteria: * unwilling or unable to give informed consent or refuse to be randomized * have cognitive impairments or psychiatric conditions that preclude consent * are currently involved in other intervention trials * are failing on dialysis and approaching end of life (supportive/palliative care pathway)
asthma control in a dutch primary care population

Conditions: Asthma; Asthma; Eosinophilic; Asthma Chronic; Asthma; Status

Summary: rationale: despite the availability of effective treatment to reach symptom control, nearly half of the asthma patients remain inadequately controlled. there is a need for timely and appropriate treatment of patients with uncontrolled asthma. improving asthma control could be achieved by a better identification of causes followed by remediating modifiable factors in primary care or referral to secondary care. however, major gaps in evidence-based asthma practice exist in primary care. so far, there is a lack of knowledge on the prevalence of inadequate asthma and associated characteristics. objective: the primary objective is to determine the proportion of primary care patients with inadequate asthma control, as assessed during a regular control consultation with the general practice nurse. study design: this is a non-interventional prospective observational study, taking place in a real-world primary care setting. the asthmaoptimiser tool will be used during regular asthma consultations in primary care, which the healthcare provider will fill in together with the patient. the asthmaoptimiser tool creates an overview of factors and characteristics that may be associated with uncontrolled asthma, and subsequently provides a guideline-based management suggestion. additionally, we will perform qualitative interviews to collect experiences and perspectives of healthcare providers on their use of the asthmaoptimiser tool, including, but not limited to, ease of use, points of improvement, and on their implementation of the management suggestions. study population: patients diagnosed with asthma, who attend a pre-planned primary care asthma review, are eligible to participate. a limited number of in- and exclusion criteria will be adopted, to make sure the research population closely resembles the real world. main study parameters/endpoints: the primary endpoint is the proportion of patients with inadequate asthma control. inadequate asthma control will be defined as an exacerbation in the past 4 weeks and/or an acq6 (i.e., asthma control questionnaire) score \>0.75.


Eligibility criteria:
inclusion criteria: * aged ≥ 18 years * physician diagnosis of asthma * capacity to provide written informed consent exclusion criteria: * life expectancy of less than 1 year * inability to understand dutch * any other condition which, at the gps and/or investigator's discretion, is believed to present a safety risk or may impact the study results * patients participating in a clinical trial that may distort outcomes in this observational study.
clinical development of deep learning for the otosight

Conditions: Otitis Media Acute

Summary: the objective of this study is to clinically develop and evaluate a machine learning approach to improve the performance and data interpretation of the photonicare otosight middle ear scope in pediatric patients presenting at the primary care office for suspected ear infections. in this observational study, results of otosight imaging will not affect patient standard of care.


Eligibility criteria:
inclusion criteria: * pediatric patients presenting for an office visit with ear-related complaints exclusion criteria: * otoscopy contra-indicated or not possible per attending clinician's decision, down's syndrome (due to abnormalities in ear canal anatomy)

Keywords: ear infection otitis media otitis media with effusion machine learning
treatment study of soft palatal implants in obstructive sleep apnea

Conditions: Sleep Apnea, Obstructive

Summary: the purpose of the study is to compare the effectiveness of soft palatal implants with placebo and continuous positive airway pressure treatment in obstructive sleep apnea.

obstructive sleep apnea (osa), frequently associated with disruptive snoring, is a prevalent disorder which is increasingly recognized by health care providers and lay people alike as an important factor in impaired daytime executive function as well as cardiovascular disease risk. along with an increase in its recognition and diagnosis have come a growing pool of patients with milder disease and the associated challenge of ideal management. positive airway pressure (pap) is well established as the mainstay of treatment for osa since it is effective at reversing daytime neurocognitive sequelae and may be a useful adjunct to therapy in those with cardiovascular disease coexisting with osa. in patients with mild osa, however, the response to pap therapy appears muted, which is related in part to poor adherence to treatment. in response, a number of alternative treatments have evolved. the most recent innovation is soft palatal implants, which, in non-randomized, uncontrolled studies have demonstrated reasonable efficacy in the treatment of snoring and mild to moderate osa. how the implants compare with standard therapy and their effect on cardiovascular variables are unknown. because of the ease and rapidity with which this system is implanted, and because treatment effect is independent of patient compliance, there is high potential for widespread use in patients with milder osa. we therefore are conducting a randomized, placebo-controlled clinical trial to compare the impact of palatal implants with pap on sleep disordered breathing, daytime symptoms and blood pressure, as well as patient / bed partner acceptance.

Eligibility criteria:
inclusion criteria 1. age \>18 yrs 2. ahi 5-30 3. tonsil size \<50% of airway 4. no anatomically fixed nasal stenosis 5. bmi = 32 kg/m2 exclusion criteria 1. the presence of a concomitant untreated primary sleep disorder (restless legs syndrome, narcolepsy, idiopathic hypersomnia) 2. severe daytime sleepiness (history of sleep-related motor vehicle or occupational accident) 3. moderate to severe pulmonary disease (fev1 \ 180/110 7. renal disease (scr \> 2.5) 8. allergy to local anesthetics used for implantation procedure. 9. pregnant or nursing women
effects of olive oil on nipple cracking, nipple pain and maternal satisfactions

Conditions: Cracked Nipple During Lactation

Summary: the aim of the study is to evaluate the effectiveness of olive oil in the prevention of nipple cracking, nipple pain and ascension maternal satisfaction in lactating women. it's a prospective, randomized study of 80 lactating women, admitted to tri-service general hospital postpartum unit. eligible patients were randomized to olive oil group or breast milk group and evaluate the effect of olive oil for nipple pain, nipple trauma, and maternal satisfaction.

previous studies have shown that olive oil, applied to the skin, has analgesic and anti-inflammatory properties. it is proposed in this study that olive oil may also help prevent cracked nipple and sore nipple in breastfeeding mothers. the aim of the study is to evaluate the effectiveness of olive oil in the prevention of nipple cracking, nipple pain and ascension of maternal satisfaction in lactating women. it's a prospective, randomized study of 80 lactating women, admitted to tsgh postpartum unit. eligible patients were randomized into two groups of 40 women. in group 1 olive oil will be applied on the nipple after breastfeeding, and in group 2 drops of breast milk were applied to the nipple after feeding. clinical evaluations were made during the first 3 days of treatment and the 7th and 10th day after delivery. furthermore, we will check the 1month breastfeeding rate data, which collected by the hospital nurse for baby-friendly hospital policy.

Eligibility criteria:
inclusion criteria: * normal spontaneous delivery. * pregnancy weeks between 37-42. * single birth. * initiated breastfeeding. exclusion criteria: * presence of crack in the nipple. * medication applied to the nipple * the maternal health condition that may interfere with breastfeeding. * the infant with congenital abnormalities that would impair breastfeeding. * the infant attained low birth weight or other criteria to intensive care unit.
assessment of individual follow-up by coaching program for type 1 diabetes children

Conditions: Diabetes type1

Summary: the purpose of this project is to assess the introduction of an individual follow-up distance coaching (phone and messages on a secure line platform) in order to optimize the health care of type 1 diabetes children with therapy adjustment difficulties. it is a personalized, multi-disciplinary, medical et paramedical. it will consist of an individual coaching for the children and families with therapy adjustment difficulties. the hypothesis is that the proposed coaching would allow to improve the patient glycemic control not only during this coaching, but also, to bring long lasting improvement following the coaching.


Eligibility criteria:
inclusion criteria: * less than 18 years old when coaching starts. * any diabetic patient (girl or boy) who doesn't master the adjustments of the treatment according to the investigator's judgment (non-adaptations of the treatment between 2 consultations or mistakes in adapting the insulin doses, not taking properly into account previous days tendencies, food, or activities) and/or average hba1c of more than 8% during the last year. * the patient, his 2 parents or legal representatives all agree to participate in the research * absence of justice protection measures * good predictable observance of the protocol * family can be reached by phone during the coaching timetables working hours or must be listed on the platform line " mydiabby ". exclusion criteria: * non auto-immun diabetes * major understanding difficulties from the relatives (difficulties in understanding french or what anticipatory adaptation means) * the child or parents or legal representatives refuse to participate and to sign a consent * contact on the phone or on the platform impossible according to the protocol procedures * patient non-registered under social security * patient under justice protection measures

Keywords: child coaching telemedicine nurses individual follow-up